This study focuses on a comprehensive analysis of the common methods for road infrastructure monitoring, as well as the perspective of various fiber-optic sensor (FOS) realization solutions in road monitoring applications. Fiber-optic sensors are a topical technology that ensures multiple advantages such as passive nature, immunity to electromagnetic interference, multiplexing capabilities, high sensitivity, and spatial resolution, as well as remote operation and multiple physical parameter monitoring, hence offering embedment potential within the road pavement structure for needed smart road solutions. The main key factors that affect FOS-based road monitoring scenarios and configurations are analyzed within this review. One such factor is technology used for optical sensing—fiber Bragg grating (FBG), Brillouin, Rayleigh, or Raman-based sensing. A descriptive comparison is made comparing typical sensitivity, spatial resolution, measurement distance, and applications. Technological approaches for monitoring physical parameters, such as strain, temperature, vibration, humidity, and pressure, as a means of assessing road infrastructure integrity and smart application integration, are also evaluated. Another critical aspect concerns spatial positioning, focusing on the point, quasi-distributed, and distributed methodologies. Lastly, the main topical FOS-based application areas are discussed, analyzed, and evaluated.